Let's Talk About Midlife Mental Health

Do these stats surprise you?

“23% of women born in 1970 had mental health problems compared to 17% of men. Among the Baby Boomers in middle age, 19% of women born in 1958 had psychological distress compared to 11% of men, and of women born in 1946, 24% had mental ill-health, compared to 14% of men.”

The data from this 2021 University College London study I quote in the paragraph above highlights a couple of realities. First, a lot of us are dealing with mental health issues. Second, a significantly higher percentage of women than men in every age group report mental health problems. If you yourself aren’t experiencing mental health issues, it is likely you know others who are.

Many of us grew up in a time (or in a church culture) that stigmatized mental illness. To grow as Sages, we can battle that stigma right where we are by speaking honestly about mental health in the same way we do about other aspects of our physical health. I have dealt with serious depression at a couple of junctures in my life over the last 20 years. Professional counseling, supportive resources from the National Alliance for Mental Illness, and a handful of praying friends and family members carried me through those painful, dark times. If another period of clinical depression comes in my life, I am better equipped to know how and where to find help.

Dorothy Greco’s featured article below offers insight and practical wisdom on mental health for women at midlife. This piece is well worth reading and sharing. (She is also offering a book giveaway–please read to the end of her article to learn more.) We’ve got some media picks from our team, and an invitation for all of you creative souls to be a part of our upcoming December issue. Please read on!

Grateful for you,

Michelle Van Loon for the Sage Forum Team

Midlife Mental Health

Dorothy Littell Greco

My first panic attack hit in the grocery store when I was deciding whether to get broccoli or asparagus for dinner. Because I had no idea what was happening, I left my full grocery cart in the produce section, slunk out the door, and drove home. Months later, I learned about the connection between panic attacks and menopause. 

Panic attacks are just one of many mental health issues that women encounter during midlife. Though the changes in our mental health are often less obvious, our minds, like our bodies, do not escape the effects of aging. Dropping hormone levels (particularly serotonin and dopamine) combined with decreased sleep, accumulating losses, and changing family dynamics can exceed the maximum load our psyches are able to bear. This may result in panic attacks, depression, anxiety, and as was true for me, bursts of anger. (Accessing anger is not a mental health issue per se, but it can be disorienting.)

In recent years, mental health practitioners have noticed a spike in depression and anxiety for all demographics. A 2009–2012 study by the Center for Disease Control found that the highest rates of depression existed for those between the ages of forty to fifty-nine, with women besting men by five percentage points (7.2% for men and 12.3% for women). Symptoms of severe depression may manifest as a diminished capacity to work, parent, and/or engage relationally; an inability to experience pleasure or find joy (known as anhedonia in clinical terms); low energy levels; trouble concentrating; and lack of interest in normal activities. In her book Troubled Minds, Amy Simpson writes, “All mental illness, by definition, impairs a person’s basic functioning and disrupts the kind of social connections God created us to enjoy.”

Like depression, anxiety has many manifestations. Anxiety is not the same as fear or worry. Simpson believes that “fear is a response to an immediate and known threat. Anxiety is a response to a possibility.”^[1] That possibility, however vague or improbable, can have tremendous influence over us. Anxiety’s power lies in its ability to distort reality. Anxious ruminations spin every category of thought into worst-case scenarios, particularly at night when catastrophizing or despair can easily gain the upper hand. When this happens for me, I have to remind myself, “This is my 3:00 AM brain speaking.”

Mental health challenges are exacerbated by the reality that Americans—and perhaps Christians in particular—avoid talking about this topic, which can result in profound loneliness for anyone dealing with these issues. Though church communities shine in caring for people who need extra support, we can be strangely aloof or even harshly judgmental in this case.

Unlike other health issues, these silent afflictions carry a stigma. If we can’t pray it away or count on a drug to cure it, how do we make peace with and accommodate this limitation? Because mental illness contradicts our understanding of “victorious Christian living,” it’s much easier for us to judge or distance ourselves from those who suffer than it is to stay close and love, particularly if there’s no hope of an end date.^[2]

Certainly, the combination of shifting hormones and the inevitable existential questions and doubts that surface during this time are contributing factors to midlife mental health issues. Upon realizing that our lives are half finished, we are often compelled to reflect on our legacies. The questions and regrets can be daunting. Will our parenting mistakes affect our children for the remainder of their lives? Was it a miscalculation not to have children? Why did we wait so long to start investing in our retirement? How do I feel about the fact that I’ve never had the kind of professional success that I imagined or hoped for?

All these legitimate concerns should be processed with close friends and possibly with a therapist or spiritual director. By giving ourselves permission to ask difficult questions and to reflect on our lives up, we can grow in self-awareness and grieve what needs to be grieved.

Unless we’ve had a full-blown health crisis, we may be lulled into believing that we can get away with sloppy or inconsistent self-care. The truth is, we can no longer neglect our bodies without facing consequences. That said, because there’s often so much being asked of us during this season, it may be difficult to prioritize or even think about taking care of ourselves.

The terminology of self-care might be part of the problem. We often associate it with getting a massage, journaling in a hip coffee shop, or binge-watch our favorite Netflix series. Self-care might include any or all those activities, but that’s way too narrow. Self-care should mean creating a life that’s healthy, enjoyable, and sustainable for the long haul.

If we hope to be active and productive into our eighties, these five goals are imperative.

1.  Aim to reduce the amount of sugar, processed and fried foods, and alcohol that you consume. Evidence now supports that some illnesses are linked to diet and inflammation.

2.  Try to get seven hours of continuous sleep each night (this has proved to be impossible for me) and a minimum of forty-five minutes of exercise at least four times a week. This includes both weight bearing and cardiovascular exercises such as biking, brisk walking, jogging, or biking. If you aren’t currently exercising on a regular basis, start slow—aim for walking fifteen minutes every day—but do start. It’s never too late.

3. Schedule regular checkups and screenings—especially those of you who religiously avoid such unpleasantries. If your doctor is not taking you seriously or dismisses your mental health concerns, either confront them or change doctors. We need health care providers who listen to us. Hormone replacement therapy can help some women deal with symptoms that accompany menopause.

4.  Create a don’t do list.^[3] Regularly and thoughtfully evaluate what you’re doing and learn how and when to say no.

5.  See a professional therapist if you have any suicidal thoughts or if your depression or anxiety is affecting your daily life. Mental health issues can be addressed on many fronts, including therapy, life-style modification, and medication. (While pastors and church leaders can walk with us, their expertise lies in theology, church management, and spiritual formation. Most have not been trained in physical or psychological health.)

As we move through midlife, we come to understand that we will face many surprises. Though there are certain aspects of the aging process that we can’t control, it’s prudent for us to do whatever we can to keep our bodies strong and healthy so that we can continue loving and serving those around us for as long as we have breath.

The above post is an excerpt from chapter three of Marriage in the Middle: Embracing Midlife Surprises, Challenges, and Joys, by Dorothy Little Greco. You can subscribe to her Substack here. Leave a comment below or share this post and you’ll be entered in a drawing to win a free copy of this book. (US residents only.)

^[3]Amy Simpson, Anxious: Choosing Faith in a World of Worry (Downers Grove, IL: InterVarsity Press, 2014), 20-21.

^[4]Victorious Christian living, Simpson, Troubled Minds, 114.

^[5]Create a don’t do list: April Yamasaki, Four Gifts: Seeking Self-care for Heart, Soul, Mind, and Strength (Harrisonburg, VA: Herald Press, 2018), 45.

Dorothy’s Book Recommendations:

Emily McGowin’s forthcoming book, Households of Faith: Practicing Family in the Kingdom of God. Pastor and writer Emily Hunter McGowin has a gift for helping readers breathe new life into familiar spiritual practices and beliefs. She teaches us how to be ‘apprentices of love’ as we create dynamic households of faith. I wish I had this insightful book thirty years ago when I was raising my children!

Carlene Hill, Not Quite Fine: Mental Health, Faith, and Showing Up for One Another. Hill vulnerably shares from her own decades long experience with mental illness. It’s all too easy for those of us who have not struggled with significant mental health issues to turn away from those who do. Byron helps readers to understand how to show up and be a good friend.

Julia Hotz, The Connection Cure: the Prescriptive Power of Movement, Nature, Art, Service, and Belonging. I would so welcome the revolution in health care that Hotz proposes. Instead of doctors asking What’s the matter with you? they ask, What matters to you? By shifting the focus start prescribing cures connected to moving, nutrition, community, art, and nature, we can move toward healing more holistically.

What resources or organizations have you found helpful?

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November Media Picks From The Sage Team

[BOOK] Measured by Grace: How God Defines Success by Sharla Fritz. I love success—working hard, being rewarded for doing a good job, coming out on top, basking in approval. But God defines success differently. Through the Biblical stories of Joseph, Rahab, David, Jeremiah, John the Baptist, the Samaritan woman, Peter, and Paul, Sharla Fritz explores the concept of success, which often looks like failure to us, but not in the eyes of God. A readable Bible study with chapter-by-chapter guide and answer key. The Women’s Ministry at my church is using this book for their current group study. Highly recommend. (CD) P.S. from the editor: Sharla Fritz is a valued member of the Sage Forum team!

[VIDEO-Amazon Prime] It All Begins With A Song. Even if you’re not a country music fan, this documentary throws open a window on the songwriting process. The final scenes of this inspiring film brought me to tears, in a good way. (MV)

[BOOK] New York by Edward Rutherfurd. One of my favorite reading genres is historical fiction and few do it as well as Rutherfurd. New York, like Sarum, London and Paris which I have previously read, is a masterpiece of historical knowledge illuminated through creative storytelling. (RC)

[BOOK] Europe 101: History & Art for the Traveler by Rick Steves and Gene Openshaw. You may be familiar with Rick Steves from his many travel shows featured regularly on PBS. Though I am a lifelong history lover, after a recent trip to Europe I realized there were some significant gaps in my knowledge about Europe’s past before World War I. Europe 101 offers a great overview of political, cultural, and religious history, often delivered with a measure of humor. This guide is a compelling a read as a novel. (MV)

What are you reading, listening to, or watching this month?

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You’re invited!

We’d LOVE to see or read your creative take on the theme of hope in the darkness. Please email your submissions to us at thesageforum123@gmail.com before Friday, November 22nd, and we may share your work with our readers in next month’s Sage Forum newsletter.

Finally, as the U.S. faces a consequential election next week, a prayer from David O. Taylor’s Prayers for the Pilgrimage:

O Lord, you who are the lover of concord, help us, we pray, not to become needlessly anxious over the political tempests that rage across the landscape of our land but rather to trust in your providential care, so that we might remain peacemakers to friend and stranger alike this day. We pray this in the name of Jesus, the One who holds all things together. Amen.

Photos by Priscilla Du Preez 🇨🇦, Kristina Tripkovic , Abderrahmane Meftah on Unsplash

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